Nicholas Mantovani, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

109439 Issued in CA

Practice address

4309 Stagecoach Rd
Dunsmuir, CA 96025-1812

Phone

(530) 235-4138

NPI assigned

Sep 19, 2023

Last updated

Sep 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: nicholas.mantovani.1@25248.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1992583132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1143",
            "city": "MCCLOUD",
            "state": "CA",
            "postal_code": "960571143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 STAGECOACH RD",
            "city": "DUNSMUIR",
            "state": "CA",
            "postal_code": "960251812",
            "telephone_number": "530-235-4138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTOVANI",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cascade Emergency Medicine Inc. (Mountain Medics Inc.)
• Brittany Collier, ASW
• Dunsmuir Elementary School District
• Dunsmuir Joint Union High
• McCloud Healthcare Clinic, Inc. (Shasta Cascade Health Centers- Dunsmuir)
• McCloud Healthcare Clinic, Inc.
• Brenda Montano
• Timothy Howard Seidlitz, O.D.
• Tejendra Bahadur Srivastava, M.D.

• Dentist in Dunsmuir, CA
• Providers in Dunsmuir, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.